Group B streptococcal empyema necessitatis with pleural fistula after blunt trauma: A case report. (2019)

• Record Type: Journal Article
• Authors: Ohki, Takashi; Shigematsu, Yoshiki; Hatooka, Shunzo
• Is Part Of: International journal of surgery case reports. Volume 63(2019)
• Page Start: 44
• Page End: 47
• Publication Date: 2019
• Subjects: CT computed tomography -- EN empyema necessitatis -- GBS group B Streptococcus -- HbA1c glycated hemoglobin; Empyema necessitatis -- Septic arthritis -- Group B Streptococcus -- Blunt trauma; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2019.09.006
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Empyema necessitatis (EN) occurred with a pleural fistula after blunt chest trauma. We report the first case of group B streptococcal (GBS) EN resulting from trauma. Septic arthritis occurred after open-window thoracotomy. GBS infection might become invasive in immunocompromised patients. Careful follow-up of such patients who develop a new focus of infection is important. Abstract: Introduction: We report the first case of empyema necessitatis (EN) with pleural fistula and septic arthritis caused by Streptococcus agalactiae following blunt trauma. Presentation of the case: A 46-year-old man with diabetes mellitus and a history of recent right rib fracture and right knee bruising presented with dyspnea and right knee pain. He was diagnosed with EN and underwent chest drainage, followed by open-window thoracotomy. Septic arthritis occurred on day 8 after thoracotomy. The chest wall wound healed after 3 months. Discussion: EN is a rare complication of empyema. In this patient, infection was invasive, causing necrotizing pneumonia with a pleural fistula. To our knowledge, there are no reports of group B streptococcal EN with a pleural fistula resulting from blunt chest trauma. Conclusion: Group B streptococcal infection might become invasive in immunocompromised patients, so careful follow-up for those patients is important.